<template>
  <div>
    <el-row :gutter="15">
      <el-form ref="elForm" :model="formData" :rules="rules" size="medium" label-width="100px">
        <el-col :span="24">
          <el-form-item label-width="65px" label="筛查员" prop="field102">
            <el-input v-model="formData.field102" placeholder="请输入筛查员" clearable :style="{width: '100%'}">
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="120px" label="脑卒中（中风）" prop="field101">
            <el-radio-group v-model="formData.field101" size="medium">
              <el-radio v-for="(item, index) in field101Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-radio>
            </el-radio-group>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="134px" label="脑卒中与本人关系" prop="field103">
            <el-checkbox-group v-model="formData.field103" size="medium">
              <el-checkbox v-for="(item, index) in field103Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-checkbox>
            </el-checkbox-group>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item label-width="92px" label="脑卒中患病" prop="field104">
            <el-input v-model="formData.field104" placeholder="请输入脑卒中患病人数" clearable :style="{width: '100%'}">
              <template slot="append">人</template>
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="65px" label="冠心病" prop="field105">
            <el-radio-group v-model="formData.field105" size="medium">
              <el-radio v-for="(item, index) in field105Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-radio>
            </el-radio-group>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="134px" label="冠心病与本人关系" prop="field106">
            <el-checkbox-group v-model="formData.field106" size="medium">
              <el-checkbox v-for="(item, index) in field106Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-checkbox>
            </el-checkbox-group>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item label-width="92px" label="冠心病患病" prop="field107">
            <el-input v-model="formData.field107" placeholder="请输入冠心病患病人数" clearable :style="{width: '100%'}">
              <template slot="append">人</template>
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="65px" label="高血压" prop="field108">
            <el-radio-group v-model="formData.field108" size="medium">
              <el-radio v-for="(item, index) in field108Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-radio>
            </el-radio-group>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="134px" label="高血压与本人关系" prop="field109">
            <el-checkbox-group v-model="formData.field109" size="medium">
              <el-checkbox v-for="(item, index) in field109Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-checkbox>
            </el-checkbox-group>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item label-width="92px" label="高血压患病" prop="field110">
            <el-input v-model="formData.field110" placeholder="请输入高血压患病人数" clearable :style="{width: '100%'}">
              <template slot="append">人</template>
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="65px" label="糖尿病" prop="field111">
            <el-radio-group v-model="formData.field111" size="medium">
              <el-radio v-for="(item, index) in field111Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-radio>
            </el-radio-group>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="134px" label="糖尿病与本人关系" prop="field112">
            <el-checkbox-group v-model="formData.field112" size="medium">
              <el-checkbox v-for="(item, index) in field112Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-checkbox>
            </el-checkbox-group>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item label-width="92px" label="糖尿病患病" prop="field113">
            <el-input v-model="formData.field113" placeholder="请输入糖尿病患病人数" clearable :style="{width: '100%'}">
              <template slot="append">人</template>
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="78px" label="高血脂症" prop="field114">
            <el-radio-group v-model="formData.field114" size="medium">
              <el-radio v-for="(item, index) in field114Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-radio>
            </el-radio-group>
          </el-form-item>
        </el-col>
        <el-col :span="12">
          <el-form-item label-width="148px" label="高血脂症与本人关系" prop="field115">
            <el-checkbox-group v-model="formData.field115" size="medium">
              <el-checkbox v-for="(item, index) in field115Options" :key="index" :label="item.value"
                :disabled="item.disabled">{{item.label}}</el-checkbox>
            </el-checkbox-group>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item label-width="105px" label="高血脂症患病" prop="field116">
            <el-input v-model="formData.field116" placeholder="请输入高血脂症患病人数" clearable
              :style="{width: '100%'}">
              <template slot="append">人</template>
            </el-input>
          </el-form-item>
        </el-col>
        <el-col :span="24">
          <el-form-item size="large">
            <el-button type="primary" @click="submitForm">提交</el-button>
            <el-button @click="resetForm">重置</el-button>
          </el-form-item>
        </el-col>
      </el-form>
    </el-row>
  </div>
</template>
<script>
export default {
  components: {},
  props: [],
  data() {
    return {
      formData: {
        field102: undefined,
        field101: "",
        field103: [],
        field104: undefined,
        field105: "",
        field106: [],
        field107: undefined,
        field108: "",
        field109: [],
        field110: undefined,
        field111: "",
        field112: [],
        field113: undefined,
        field114: "",
        field115: [],
        field116: undefined,
      },
      rules: {
        field102: [],
        field101: [],
        field103: [],
        field104: [],
        field105: [],
        field106: [],
        field107: [],
        field108: [],
        field109: [],
        field110: [],
        field111: [],
        field112: [],
        field113: [],
        field114: [],
        field115: [],
        field116: [],
      },
      field101Options: [{
        "label": "无",
        "value": 1
      }, {
        "label": "有，与本人关系：",
        "value": 2
      }, {
        "label": "不详",
        "value": 3
      }],
      field103Options: [{
        "label": "父亲",
        "value": 1
      }, {
        "label": "母亲",
        "value": 2
      }, {
        "label": "兄弟姐妹",
        "value": 3
      }],
      field105Options: [{
        "label": "无",
        "value": 1
      }, {
        "label": "有，与本人关系：",
        "value": 2
      }, {
        "label": "不详",
        "value": 3
      }],
      field106Options: [{
        "label": "父亲",
        "value": 1
      }, {
        "label": "母亲",
        "value": 2
      }, {
        "label": "兄弟姐妹",
        "value": 3
      }],
      field108Options: [{
        "label": "无",
        "value": 1
      }, {
        "label": "有，与本人关系：",
        "value": 2
      }, {
        "label": "不详",
        "value": 3
      }],
      field109Options: [{
        "label": "父亲",
        "value": 1
      }, {
        "label": "母亲",
        "value": 2
      }, {
        "label": "兄弟姐妹",
        "value": 3
      }],
      field111Options: [{
        "label": "无",
        "value": 1
      }, {
        "label": "有，与本人关系：",
        "value": 2
      }, {
        "label": "不详",
        "value": 3
      }],
      field112Options: [{
        "label": "父亲",
        "value": 1
      }, {
        "label": "母亲",
        "value": 2
      }, {
        "label": "兄弟姐妹",
        "value": 3
      }],
      field114Options: [{
        "label": "无",
        "value": 1
      }, {
        "label": "有，与本人关系：",
        "value": 2
      }, {
        "label": "不详",
        "value": 3
      }],
      field115Options: [{
        "label": "父亲",
        "value": 1
      }, {
        "label": "母亲",
        "value": 2
      }, {
        "label": "兄弟姐妹",
        "value": 3
      }],
    }
  },
  computed: {},
  watch: {},
  created() {},
  mounted() {},
  methods: {
    submitForm() {
      this.$refs['elForm'].validate(valid => {
        if (!valid) return
        // TODO 提交表单
      })
    },
    resetForm() {
      this.$refs['elForm'].resetFields()
    },
  }
}

</script>
<style>
</style>
